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Psychological, pharmacological, and combined treatments for binge eating disorder: a systematic review and meta-analysis

Journal article
Authors A. Ghaderi
J. Odeberg
S. Gustafssoros
Maria Råstam
A. Brolund
A. Pettersson
T. Parling
Published in Peerj
Volume 6
ISSN 2167-8359
Publication year 2018
Published at Gillberg Neuropsychiatry Centre
Language en
Links doi.org/10.7717/peerj.5113
Keywords Eating disorder, Psychotherapy, Meta-analysis, Binge eating disorder, SSRI, Lisdexamfetamine, cognitive-behavioral therapy, placebo-controlled trial, randomized, controlled-trial, guided self-help, controlled monotherapy trial, diverse obese-patients, weight-loss treatment, double-blind trial, clinical-trial, interpersonal psychotherapy, Science & Technology - Other Topics
Subject categories Psychiatry

Abstract

Objective: To systematically review the efficacy of psychological, pharmacological, and combined treatments for binge eating disorder (BED). Results: We found 45 unique studies with low/medium risk of bias, and moderate support for the efficacy of cognitive behavior therapy (CBT) and CBT guided self-help (with moderate quality of evidence), and modest support for interpersonal psychotherapy (IPT), selective serotonin reuptake inhibitors (SSRI), and lisdexamfetamine (with low quality of evidence) in the treatment of adults with BED in terms of cessation of or reduction in the frequency of binge eating. The results on weight loss were disappointing. Only lisdexamfetamine showed a very modest effect on weight loss (low quality of evidence). While there is limited support for the long-term effect of psychological treatments, we have currently no data to ascertain the long-term effect of drug treatments. Some undesired side effects are more common in drug treatment compared to placebo, while the side effects of psychological treatments are unknown. Direct comparisons between pharmaceutical and psychological treatments are lacking as well as data to generalize these results to adolescents. Conclusion: We found moderate support for the efficacy of CBT and guided self-help for the treatment of BED. However, IPT, SSRI, and lisdexamfetamine received only modest support in terms of cessation of or reduction in the frequency of binge eating. The lack of long-term follow-ups is alarming, especially with regard to medication. Long-term follow-ups, standardized assessments including measures of quality of life, and the study of underrepresented populations should be a priority for future research.

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